02832nas a2200265 4500000000100000008004100001260003400042653002700076653002400103653001600127100001600143700001400159700001500173700001400188700001400202700001500216700001000231700001100241700001100252700001400263700001200277245014700289520210500436022002502541 2021 d bOxford University Press (OUP) 10 aMicrobiology (medical) 10 aInfectious Diseases 10 aAlbendazole 1 aOuattara AF 1 aBjerum CM 1 aAboulaye M 1 aKouadio O 1 aMarius VK 1 aAndersen B 1 aLew D 1 aGoss C 1 aWeil G 1 aKoudou BG 1 aKing CL 00 aSemiannual Treatment of Albendazole Alone is Efficacious for Treatment of Lymphatic Filariasis: A Randomized Open-label Trial in Cote d'Ivoire 3 aAbstract
Background
Ivermectin (IVM) plus albendazole (ALB), or IA, is widely used in mass drug administration (MDA) programs that aim to eliminate lymphatic filariasis (LF) in Africa. However, IVM can cause severe adverse events in persons with heavy Loa loa infections that are common in Central Africa. ALB is safe in loiasis, but more information is needed on its efficacy for LF. This study compared the efficacy and safety of three years of semiannual treatment with ALB to annual IA in persons with bancroftian filariasis.
Methods
Adults with Wuchereria bancrofti microfilaremia (Mf) were randomized to receive either three annual doses of IA (N=52), six semiannual doses of ALB 400mg (N=45), or six semiannual doses of ALB 800mg (N=47). The primary outcome amicrofilaremia at 36 months.
Findings
IA was more effective for completely clearing Mf than ALB 400mg or ALB 800mg (79%, CI 67-91; vs. 48%, CI 32-66 and 57%, CI 41-73, respectively). Mean % reductions in Mf counts at 36 months relative to baseline tended to be greater after IA (98%, CI 88-100) than after ALB 400mg (88%, CI 78-98) and ALB 800mg (89%, CI 79-99) (P=0.07 and P=0.06, respectively). Adult worm nest numbers (assessed by ultrasound) were reduced in all treatment groups. Treatments were well tolerated.
Interpretation
Repeated semiannual treatment with ALB is macrofilaricidal for W. bancrofti and leads to sustained reductions in Mf counts. This is a safe and effective regimen that could be used as MDA to eliminate LF in areas ivermectin cannot be used.
a1058-4838, 1537-6591